Kamel Abou Hussein, MD, explains why breast oncologists score programmed death-ligand 1 (PD-L1) using the combined positive score (CPS) rather than the tumor proportion score, since PD-L1 expression in breast cancer sits mainly in the immune microenvironment
Benjamin Levy, MD, opens a discussion with Kamel Abou Hussein, MD, Nicholas Hornstein, MD, PhD, and Nicole Balmaceda, MD, on how biomarkers differ across tumor types, then explains how programmed death-ligand 1 (PD-L1) guides treatment in non-small cell lung cancer.
In the program's closing segment, the panel shares practical pearls and reflections for clinicians.
The panel explores the rationale and emerging data for combining ADCs with immunotherapy and other targeted agents.
The panel discusses the notably low treatment discontinuation rates seen with ADCs in both pivotal trials compared with chemotherapy, and whether these reassuring numbers translate to real-world practice.
The panel reviews the distinct adverse event profile associated with datopotamab deruxtecan, moving from least to most common.
The panel takes a deeper look at neutropenia, one of the adverse events of special interest with sacituzumab govitecan.
The panel addresses one of the field's most pressing practical questions: what to offer after a first-line ADC, acknowledging that no prospective data yet exist to guide the decision.
The panel explores how to assign value to different trial endpoints in an aggressive disease, discussing overall survival as the gold standard while considering how crossover and confounding factors complicate its interpretation, and where PFS2 fits as a measure that reflects benefit across lines of therapy.
With both pivotal trials reviewed, the panel discusses how to reconcile the data when counseling an individual patient.
The panel reviews the TROPION-Breast02 findings, offering equipoise alongside the prior discussion of ASCENT-03.
The panel takes a closer look at ASCENT-03, framing it as a study designed to test whether a TROP2-directed ADC could serve as a first-line alternative to chemotherapy.
The panel turns to the design of two pivotal first-line trials, framing the discussion not as a head-to-head comparison but as a way to inform patient selection in clinic.
The panel addresses one of the more difficult challenges in metastatic TNBC: central nervous system involvement.
The panel discusses the rationale for using effective agents in the first-line metastatic setting rather than reserving them for later lines, considering the disease's aggressive course and limited expected survival alongside the trajectories seen in other breast cancer subtypes.
The panel reviews how the metastatic TNBC treatment paradigm has evolved, tracing TROP2-directed ADCs from later-line use into the first-line setting.
The panel grounds the discussion in the biology and natural history of metastatic triple-negative breast cancer, framing it as a high-proliferation subtype prone to rapid resistance, in which the first-line setting offers an important opportunity to influence outcomes. Panelists outline a biomarker-driven treatment algorithm stratified by PD-L1 status, germline BRCA status, and prior early-stage therapy, touching on immune checkpoint inhibition, PARP inhibitors, platinum-based chemotherapy, and the role of antibody-drug conjugates across lines of therapy.
Clinicians debate sequencing breast cancer ADCs, weighing back‑to‑back use vs chemo breaks, and managing ILD, nausea, fatigue, cardiotoxicity.
How doctors sequence ADCs, pick the best first option, and manage T-DXd ILD, nausea and fatigue in metastatic breast cancer.
ASCENT-04 shows SG plus pembrolizumab boosts PFS without extra toxicity in PD-L1+ TNBC, while trials test IO for PD-L1− disease.
New trials redefine HER2 ultra-low disease, guiding when to use T-DXd vs oral chemo and emerging Trop-2 ADC options.
DB-06 reshapes HER2 testing with ultra-low disease, guiding T-DXd timing and comparing Trop-2 ADC options by toxicity and survival data.
New first-line TDxd plus pertuzumab reshapes HER2+ metastatic care, doubling PFS and sparking debate on maintenance and CNS control.
Explore risk‑adapted T‑DXd use in early HER2+ breast cancer—who benefits, how to sequence therapy, and ILD monitoring hurdles.
Emerging trials show trastuzumab deruxtecan boosts pCR and disease-free survival in early HER2-positive breast cancer, reshaping neoadjuvant/adjuvant care with ILD monitoring.
Panelists discuss how innovative HER2-targeted strategies and precision approaches will define the next era of breast cancer therapy.
Panelists discuss how new trial results from ASCENT-03 and TROPION-Breast02 are shaping next-generation TNBC therapies.
Panelists discuss how molecular characterization and novel agents are redefining the management of TNBC.
Panelists discuss how HER2-low and HER3-directed therapies are expanding precision treatment opportunities in metastatic breast cancer.
Panelists discuss how newer HER2-targeted therapies show promise for CNS disease control and broader metastatic management.
